Breast Implants (Augmentation)

Breast augmentation is a surgical procedure in which an implant is inserted to increase breast volume. Patients choose breast implants for a variety of reasons — to restore volume to the breasts after significant weight loss or breast feeding, or simply to enlarge naturally smaller breasts.

Whatever your reason for breast augmentation, you’re bound to have some questions. Below, you’ll find answers to some of common questions we’re asked about breast implants. Remember, if you have specific questions not addressed here, or if you would like to learn about the many options available to meet your particular needs, body and breasts, your best bet is to come in for a consultation with Dr. Deutsch.

What size implant do I choose?

Deciding on breast implant size is a personal decision. What’s “right” for one woman may not be for another. You will need to take into account your body shape, the size of your body frame, and your chest and breast measurements in order to find a size that looks natural. Obviously, your personal desires in terms of aesthetic outcome and what you are trying to accomplish are also considerations.

During a breast augmentation consultation with Dr. Deutsch, measurements will be taken of your breast width and the distance between your sternal notch (the indentation above the breast bone) and nipple. These measurements will help determine the best size implant for you.

Keep in mind when you’re discussing your desired breast size, breast implants are measured by their volume in cubic centimeters (CCs), rather than with a letter based on your bra cup size. One CC is equal to one milliliter. The higher the CC, the larger the implant.

How and where will the implant be inserted?

The implant can be inserted either under or on top of the pectoralis muscle. The muscle provides soft tissue coverage and helps shape the upper portion of the breast. Placing an implant under the muscle is beneficial for women who do not have a lot of natural tissue because it can provide a more natural appearance. On the other hand, if you have a good amount of breast tissue or choose the softer saline implant, we may suggest placing the implant on top of the muscle. Dr. Deutsch will determine which placement is best based on your unique physiology.

As with placement, there are two different incision styles. The implant can be inserted through a small incision at the lower border of the nipple area (called the areola) or through a small incision in the fold under your breast (called the inframammary crease). This is something else Dr. Deutsch will discuss with you.

What’s best—saline or silicone implants?

There’s no right or wrong option when choosing the filing of your implant. It’s totally a personal preference. Silicone implants are being used more often now for several reasons. Compared to the implants from the 1990s, these newer implants have a thicker shell and a thicker gel inside. Furthermore, the fears that existed from the early 1990s of medical problems from ruptured implants are unfounded. One of the biggest pluses with silicone implants is they provide patients with a more natural look and feel than saline implants do. Silicone implants are pre-filled with a thick and sticky gel. The gel mimics the feel of breast for a more natural appearance and feel. Women who are 22 years old or older can receive silicone implants. Saline implants are less expensive than the silicone implants and give some patients peace-of-mind knowing there’s only sterile saline inside the implants. (If the implant ruptures, the sterile salt water will naturally be absorbed by your body and poses no health risks, although the deflated implant will need to be removed and replaced.) Saline implants are inserted while empty and then filled with a sterile salt water solution once they are in place. This style of implant is available to women 18 years of age or older. There’s no right or wrong option when it comes to breast implant fillings. It’s a completely personal preference.

Perimeter Plastic Surgery works with all breast implant companies, including Allergan, Mentor, and Sientra. By doing so, this allows Dr. Deutsch to assess the patients’ individual needs to obtain the best cosmetic results.

What is the recovery time after breast augmentation surgery?

Most patients do not have a significant amount of pain after surgery, and some patients can return to work as early as 1-2 days after their procedure. However, women should not do any heavy lifting for at least four weeks.

What is the best approach to achieve the most natural look?

The key to achieving natural results is to understand your options so you make the right choices prior to the procedure. There many different options available to you in terms of breast implant size, shape, composition and placement. What’s best-suited for you will in big part be determined by your height, weight, body frame and overall size.

One of the most important recommendations we make to patients is to opt for a breast size that’s proportional to your figure and not significantly larger than the size you are now. For example, if someone with a small body frame wears an “A” cup size and wants implants to become a “DD” cup size, the results may not seem natural. In order to achieve a “natural look,” the implant must fit your chest width and be in proportion with the rest of your body. Placement is also an issue. If the implants are placed so that your breasts sit high on your chest and your cleavage is tight, it will look fake. On the other hand, when the implants are placed under the muscle, not over it, and most of the breast volume is in the lower half, you achieve a more natural appearance. You will have a natural slope that takes off from your chest and projects forward towards the nipple.

Another factor that comes into play is the “profile” of the implant type. “Profile” refers to the dimension of an implant, and more specifically, the width and projection (how much the implant projects forward). There are low profile implants and high profile implants. Low profile implants have a wider base and do not have a great deal of projection. High profile implants offer more projection and their bases are narrower, so the implant has more of a “ball” shape than low profile breast implants. In general, the lower profile implants give a more natural look. Of course, every woman’s body is different. What’s the best option for one person may not be for another. The size and volume of breast implants are best decided upon during a thorough examination and consultation with a board-certified plastic surgeon.

Can you exercise after a breast augmentation?

Dr. Deutsch advises breast augmentation patients to wait at least three weeks after the surgery to start exercising again. This will allow the body time to heal and control the amount of swelling in the breast area. Patients should start out with low impact exercise routines (such as a stationary bike or elliptical machine), and wait 4 to 6 weeks before beginning high impact exercise like running.

Do you have to replace breast implants?

Back in the day, people had to replace breast implants more frequently than they do now. The breast implants used today are the most advanced breast implants available, and have a thicker gel and more durable shell compared to earlier implants from years ago. As a result, breast implants last much longer today than they used to.

Still, breast implants don’t last forever and will need to be replaced approximately every 15-20 years. Replacing the implants in the breast is a procedure that can be discussed with Dr. Deutsch. It’s a safe procedure that is performed under general anesthesia. The overall process and recovery period following just the replacement of the implants is less than the initial insertion of implants into the breasts. If you’d like to know more about the replacement or even the removal of breast implants, Dr. Deutsch would be happy to discuss this with you in a phone or office consultation.